Omkar Venkatesh

[Omkar Venkatesh @OmkarGV]

What's the formula for naming a biopharma company? Seems like you need a classical reference, preferably a European one that sounds like a Harry Potter spell. Excelsior Therapeutics. Ostinato Pharma. Or a Greek constellation? Kentaurus Bio. Antinous Bio. Cameleopardalis Bio.

[Omkar Venkatesh @OmkarGV]

@dbsable @BiotechElmo @Prof_Oak_ Appreciate it! Just to clarify, the gonadotropin data is from humans. Overall, sounds not super concerning given no impact on androgens. They note some acne, but maybe a different mechanism.

Full paper here:
https://t.co/ffYWvG7z1x

[Omkar Venkatesh @OmkarGV]

@MichaelGIsonMD @NM_Transplant Congratulations to you and the team Dr. Ison! It feels surreal that this may be going into our patients'/loved ones' arms in less than a year and reducing death/disease from RSV-- looking forward to observing AdCom and ACIP discussion.

[Omkar Venkatesh @OmkarGV]

@f2harrell @EBRheum @vandy_biostat @EdgeforScholars My suspicion is that there is no generalizable answer to this question -- as it's what clinicians struggle with daily (i.e. how different is x RCT from y patient).

Separately, totally agree with your take that we shouldn't sandbag adherence to improve external validity of RCTs.

[Omkar Venkatesh @OmkarGV]

@LauringLab @jpogue1 Absolutely not if it lead to the emergence of long branch influenza variants that would not have existed normally. Moreover, influenza already has a high baseline mutation rate (and doesn't need the "help" as much as SARS CoV 2). Pandemic risk is a form of "toxicity."

[Omkar Venkatesh @OmkarGV]

@msiuba @heart_lung Appreciate it -- my proposed explanation after thinking on this is time scale -- the lecture I cited above is for beat-to-beat variation in preload. Whereas in RAAS-hyperactive patients needing diuresis they are spending most of their time in the flat/declining part of F-S curve

[Omkar Venkatesh @OmkarGV]

@msiuba @heart_lung Also a separate discussion for another time is the difference of RV failure in PHTN (incr afterload) to RVMI (primary pump failure), where, too, there seems to be controversy about preload dependence: https://t.co/thLxDd6xyg

[Omkar Venkatesh @OmkarGV]

@msiuba @heart_lung here is, roughly timestamped, the discussion: https://t.co/RETK1mhJ4y

[Theo Sanderson @theosanderson]

💥 New preprint out today

We conclusively demonstrate that mutational events caused by molnupiravir treatment can be seen in globally sequenced SARS-CoV-2 genomes, in some cases with onwards transmission.
🧵
https://t.co/nQwbu4ZpsS

[Omkar Venkatesh @OmkarGV]

@ZacharyBrennan It's going to hurt patients in the nth indication. If you're Takeda and you have 9 years of exclusivity, and a year after launch a KOL approaches you and says let's try it in my disease. By the time trials finish, you'll have maybe 2 years before price control on that indication

[Omkar Venkatesh @OmkarGV]

Prof @LauringLab is one of the top experts in RNA viral evolution. As he points out, next step is to check if patients from which "long branches" were isolated received molnupiravir. That might provide a smoking gun. Until then, tough to say definitively

https://t.co/KbcqWkscqH

[Omkar Venkatesh @OmkarGV]

Like many people, I've been concerned about molnupiravir for a while, but have seen some especially concerning evidence and commentary from experts in recent weeks. (1/4)

[Omkar Venkatesh @OmkarGV]

3. Mechanistically, if you inactivate CoV proofreading, the virus stays active for generations. Molnupiravir works by inducing lethal mutations. So it would seem the virus is hardier than thought. See commentary by RNA virol. @wanderer_jasnah here:
https://t.co/d6pROMwBIG (4/4)

[Omkar Venkatesh @OmkarGV]

@JackScannell13 @ablT315I @ideapharma That is to say before reallocating all that R&D $ to (e.g.) smoking cessation we should consider those effects. Could argue that nothing special about onc vs. other indic. and it's just more incentivized. But the dz biology and shorter endpoints may uniquely facilitate innovation

[Omkar Venkatesh @OmkarGV]

@JackScannell13 @ablT315I @ideapharma Thanks -- I suspect there's not so much divergence. Totally agree more efficient onc R&D would benefit everyone. My main point is that social return of onc R&D is more than the OS benefits in the near term -- it also includes the cascading effects of technological advancement

[Omkar Venkatesh @OmkarGV]

@JackScannell13 @ablT315I @ideapharma I am also sympathetic to the idea that oncology is overrepresented in research $. But IMO the idea that onc leads other indications is the strongest counter argument. PS -- agree that disease models = public goods which means they are under-incentivized in the status quo (2/2)

[Omkar Venkatesh @OmkarGV]

@JackScannell13 @ablT315I @ideapharma I watched the webinar, and agree with a lot of it. This point goes unaddressed, however. If all of oncology R&D yielded no drugs except the COVID vaccines, that would still be a net positive for society. Many other examples include cell therapy, rituxan, JAKi, etc. etc. (1/2)